The meaning and impact of nonverbal behavioral expression in decisions about artificial nutrition and hydration for patients with advanced dementia

Direction: Ralf J. Jox, MD, PhD
Collaborators: Gian Domenico Borasio, MD; Christian Kolb
Staff: Katja Kuehlmeyer, Dr. rer. biol. hum.
Doctoral Candidate: Anna F. Schuler
Funding: Stifterverband für die Deutsche Wissenschaft, Lehre@LMU
Duration: June 2012 – December 2015

In this project we are investigating the meaning and impact of nonverbal behavioral expressions of patients with advanced dementia during the administration of foods and fluids. At first we will investigate the current practice by conducting an empirical mixed methods study with professionals that are involved in the care for patients with dementia and are confronted with decisions about artificial nutrition and hydration. A qualitative interview study with experts allows an analysis of typical situations. A quantitative survey with nurses allows a description of the frequency of such situations. The study can give an insight into the interpretations of meaning of the behavioral expressions and their subjective value for decisions about artificial nutrition and hydration. Based on the findings of the empirical study we analyze which reasons can be identified for the interpretation of nonverbal expressions as the patient’s will to live/die or for the interpretation of the patient’s well-being. The results of the study are to inform and contribute to an improved decision-making process for patients with advanced dementia.